Organization
JERZY GRZEBIELUCH, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERZY GRZEBIELUCH MD (OWNER)
(850) 864-2008
Entity
Organization
Contact information
Practice address
4 2ND ST SE, FORT WALTON BEACH, FL 32548-5502
(850) 864-2008
(850) 864-5008
Mailing address
4 2ND ST SE, FORT WALTON BEACH, FL 32548-5502
(850) 864-2008
(850) 864-5008
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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